Why Is My Blood Sugar High In The Morning When It Was Perfect When I Went To Bed?

by mratner

The rebounding blood sugar following undetected diabetic hypoglycemia can easily become chronic when the high morning blood sugar data is misjudged to be due to insufficient nighttime insulin delivery. (Photo credit: Wikipedia)

I saw this question today and I’d like to give it moment because it is an excellent and common question. The reason this happens is related to our bodies having a natural rhythm in which they release glucose into the system and at the same time, our bodies metabolize these sugars at different rates throughout the day.

Typically, someone on insulin therapy will need higher basal doses in the mornings. This happen for two reasons. One, in the early morning hours, our body starts to kick out glucose that we will need for things like waking up, moving around, conscious thought. Yes, thinking on purpose requires more fuel than daydreaming. The second reason is that our bodies generally metabolize those sugars at a slower rate in the morning. Put the two together and your 107 mg/dL at bedtime can easily turn into 253 mg/dL at 8:00 am. Sucks, huh?

And, sometimes, you drop low in the night without knowing it and your body naturally “rebounds” to save itself. See photo at right. —>

So, what do you do about it?

Well, you can adjust your pump settings to a higher temp basal rate during those early morning hours.

You can change the time of day that you inject your basal insulin if you use multiple daily injection therapy (MDI).

I find that exercising in the evening hours helps to keep my numbers stable over night but this is not for everyone. It could very easily lead to a dangerous night-time low. Go back to photo at right.

Before you do any of these things, you MUST talk to your endo or diabetes educator. True, once you have goals, settings, and techniques set up, you can (and will have to) make adjustments on your own. If you are having trouble with unstable BGL readings, you aren’t there yet. Diabetes management is very serious and trying to go it alone can be deadly. No shame in admitting you need help. After all, we weren’t born with this disease and we certainly weren’t born knowing what to do with it. So, no worries, no shame. Work with your diabetes management team and stay alive. Survive and thrive!